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� . <br /> i, . � <br /> City of Orono ��j �� <br /> Building Permit Application �/� <br /> for New Structures o Additions <br /> Mailing Add�ss: '� permit number: ,,Z�/��Cl y� <br /> A, PO Box 66 <br /> `v� Crystal Bay,MN 55323-0066 i� Date received: � �—/ -/, <br /> Street Address:' <br /> �, ,t* 2750 Kelley Parkw � � Plan review fee: G �u <br /> �' G` Orono, MN 55356 <br /> ��KfSH�4`� Main: 952-249-4600 Total Fee: <br /> Fax: 952-249-4616 www.ci.orono.mn.us �,x,� �� � <br /> This application form must be completed in full and all required information must be subm d. � �y� i/ <br /> Incomplete applications will be returned. (Please print) <br /> GENERAL INFORMATION: <br /> Job Site Address: 2000 Shadywood Rd <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No <br /> H yes,a specia/event permit is required with Police Department and City Council approva/60 days pnor to the event. Shuttle bus service will be <br /> required unless applicant demonstrates sufficient on-site parking is availab/e. Non permitted events will not be allowed. <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: Sustainable 9 Design + Build <br /> State License# BC653457 Expiration Date: 03/31/2016 <br /> Phone: (cell) 612-636-3232 (offlce) 612-234-4194 <br /> Mailing Address: 124 Main St SE, STE 343 CiN: Minneapolis ZIP: 55414 <br /> Contact Person: Ryan Hanson Applicant is: n ra / Homeowner �c�r�i.o�e� <br /> Email and/or Fax: rvanhansonCa)sustainable9.com <br /> PROPERTY OWNER INFORMATION: <br /> Name: Sustainable 9 Holdings LLC <br /> Phone(day): 612-636-3232 <br /> Address: Same as Above Ci : ZIP: <br /> Email and/or Fax Same as Above <br /> ARCHITECT/ENGINEER INFORMATION: <br /> Name: Architect/Designer-Dave Zweber, David Charlez Desi ns,Structural En ineer-Nick Hanson Hanson Group <br /> Phone(day): Dave-952.428.8200, Nick-(612)708-3572 <br /> Address: 3am ►ciimP�i ana Nnrth SuitP#d PI���dN �i5dd1 C�tY� ZIP: <br /> Email and/o�Fax: dave_zweber(cadavidcharl d ignc.com ni .k ha�{c 1 nsongrosmm�com <br /> PROJECT INFORMATION: Descri tion of ro'ect: <br /> 1.Type of Project 2.Proposed Use 3.Structure Type 4.Sewage Disposal� <br /> [�New Construction Water Supply <br /> [1�Single Family with ❑Accessory Bldg./Garage <br /> ❑Addition attached garage ❑ Deck [� Public Sewer <br /> ❑Accessory Building ❑ Single Family with Office/Commercial <br /> ❑Relocation detached garage �Residence ❑ Private Sewer <br /> ❑Other:(specify) ❑Multiple Family/Condo ❑ Retaining Wall(s) <br /> ❑Public 4-feet or greater � Public Water <br /> ""°Any earth movement may require ❑Commercial ❑Storage <br /> MCWD review 8�permlts. ❑Industrial ❑Warehouse ❑ Private Well <br /> Minnehaha Creek Watershed District(MCWD) ❑Other: (speCify) ❑Other(speCify) <br /> 15320 Minnetonka Blvd <br /> Minnetonka,MN 55345 <br /> Phone: 952-471-0590 <br /> Fax: 952-471-0682 <br /> www.minnehahacreek.o <br /> Estimated Construction Valuation (excluding land) $ 631,720.00 <br /> Packet Last Updated: August 2015 <br /> Page 21 <br />